Coiling Versus Microsurgical Clipping in the Treatment of Unruptured Middle Cerebral Artery Aneurysms: A Meta-Analysis.

摘要: Background Open microsurgical clipping of unruptured intracranial aneurysms has long been the gold standard, yet advancements in endovascular coiling techniques have begun to challenge status quo. Objective To compare with among adults middle cerebral artery (MCAA) by conducting a meta-analysis. Methods A systematic search was conducted from January 2011 October 2015 update previous All studies that reported MCAA treated or were included and cumulatively analyzed. Results Thirty-seven including 3352 patients included. Using random-effects model, pooled analysis 11 (626 aneurysms) revealed complete aneurysmal obliteration 94.2% cases (95% confidence interval [CI] 87.6%-97.4%). The 18 (759 53.2% CI: 45.0%-61.1%). Among studies, 22 assessed neurological outcomes (2404 aneurysms), favorable 97.9% 96.8%-98.6%). examined (826 95.1% 93.1%-96.5%). using fixed-effect models not materially different. Conclusion This updated meta-analysis demonstrates surgical for remains highly safe efficacious. Endovascular treatment MCAAs continues improve efficacy safety; yet, it results lower rates occlusion.